as involvement in the Asbestos Program, the HearingConservation Program, or exposure to lead. Includealso the following laboratory tests: blood type, G6PD,and sickle trait.CHRONOLOGICAL RECORD OFMEDICAL CARE (SF 600)The Chronological Record of Medical Care, SF 600,provides a current, concise, and comprehensive record ofa member’s military medical history (fig. 12-4, view Aand B). Use the SF 600 for all outpatient care and file inthe HREC. Record all visits, including those that result inreferrals to other MTFs, on the SF 600. Each personmaking an entry on the form must sign the entry andinclude his identification information (full name, gradeor rate, profession [e.g., MC, NC, etc.], and SSN), eitherhand printed, typed, or stamped.Properly maintained, the SF 600 facilitates theevaluation of a patient’s physical condition andreduces correspondence necessary to obtain medicalrecords. Appropriate use of the form also eliminatesunnecessary repetition of expensive diagnosticprocedures and serves as an invaluable permanentrecord of medical evaluations and treatments.Completing the SF 600Entries made on the SF 600 can be typewrittenwhen practical. However, entries normally arehandwritten with black or blue-black ink pens. Wheninitiating an SF 600, patient identification data shouldbe completed. Also, type or stamp the date(DD-MMM-YY) and the name and address of theactivity responsible for the entry.Use both sides of each SF 600. Preparation of anew SF 600 is not necessary each time the person isseen in a different MTF. If only a few entries arerecorded on the SF 600 at the time of a move, stamp thedesignation and location of the receiving MTF belowthe last entry and use the rest of the page to recordsubsequent visits. If the back of the SF 600 is not used,then the back needs to be crossed out and the words“This side not used,” printed in the middle of the form.SF 600s are continuous and include the followinginformation: complaints, duration of illness or injury,physical findings, clinical course, results of laboratoryor other special examinations, treatment (includingoperations), physical fitness at the time of disposition,and disposition. The subjective complaint,observation, assessment, and plan (SOAP) format maybe used for entries so long as the required informationin table 12-3 is included.Enter the following information indicated on table12-3 on the patient’s SF 600.Record each visit and the complaint described,even if a member is returned to duty without treatment.Also, document if a patient leaves before being seen.Other SF 600 EntriesOther SF 600 entries include the following:Imminent hospitalizationSpecial procedures and therapySick call visit12-13ITEM REMARKSDate A complete date must beincluded with every entry in theHREC. When an undated page ismisfiled, it is difficult to replacein proper sequence. Use thethree-letter abbreviation for themonth on all dates (e.g., 27 Apr96).MTF name Name of hospital, clinic, or shipClinicaldepartment orservice(e.g., Military Sick Call,Orthopedic Department.,etc.)Chief complaint orpurpose of visit(e.g., headache, PRTscreening, etc.)Objective findingsDiagnosis ormedicalimpressionStudies orderedand results(e.g., laboratory, X-ray, etc.)TherapiesadministeredPatientdisposition,recommendations,and patientinstructions(e.g., SIQ for 24 hours, referralto specialty clinic, etc.)Healthcareprovider’s nameand signatureInclude the provider’s grade orrate, profession (e.g., MC, NC),and SSNTable 12-3.—Required Information on an SF 600
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